Association between diminished ovarian reserve and luteal phase deficiency.

Objective: To determine the association between biomarkers of ovarian reserve and luteal phase deficiency (LPD).

Design: Secondary analysis of a prospective time-to-conceive cohort study.

Setting: Not applicable.

Screening for Psychological Conditions in Infertile Women: Provider Perspectives.

Purpose: To determine if reproductive specialists are screening new patients for depression or anxiety, explore possible reasons why providers are not screening, and assess physician's views about the impact of mental health disorders on fertility.

Materials And Methods: Cross-sectional exploratory study in which 86 practicing reproductive physicians filled out a 20-question survey regarding mental health screening and perception of psychological disorders on reproduction.

Results: The majority of infertility providers believe psychological conditions negatively impact pregnancy success (75%); however, most providers are not formally screening patients for depression or anxiety (28%).

Effects of perfluorinated chemicals on thyroid function, markers of ovarian reserve, and natural fertility.

Perfluorinated chemicals (PFCs) can act as endocrine-disrupting chemicals, but there has been limited study of their effects on ovarian reserve or fecundability. 99 women, 30-44 years old, without infertility were followed until pregnancy. Initially, serum was evaluated for Antimullerian hormone (AMH), thyroid hormones: thyroid stimulating hormone (TSH), thyroxine (T4), free thyroxine (fT4), and triiodothyronine (T3), and PFCs: perfluorooctanoate (PFOA), perfluorooctane sulfonate (PFOS), perfluorononanoic acid (PFNA), and perfluorohexanesulfonic acid (PFHxS).

Infertile women who screen positive for depression are less likely to initiate fertility treatments.

Study Question: Are infertile women who screen positive for depression less likely to initiate infertility treatments?

Summary Answer: Infertile women who screen positive for depression are less likely to initiate treatment for infertility.

What Is Already Known: Infertility imposes a psychological burden on many couples. Depression and anxiety have been demonstrated in ~40% of infertile women, which is twice that of fertile women.

Prospective evaluation of luteal phase length and natural fertility.

Objective: To evaluate the impact of a short luteal phase on fecundity.

Design: Prospective time-to-pregnancy cohort study.

Setting: Not applicable.

Thyroid Autoimmunity and Reproductive Function.

Thyroid hormones are important for normal reproductive function, and maternal thyroid dysfunction has been associated with infertility, miscarriage, preterm birth, and poor neurodevelopment in the offspring. Thyroid autoimmunity is the leading cause of thyroid dysfunction in women of reproductive age. Women with thyroid autoimmunity, even with normal thyroid function, appear to be at a higher risk for poor reproductive outcomes, including miscarriage and preterm birth.

Prospective evaluation of the impact of intermenstrual bleeding on natural fertility.

Objective: To evaluate the impact of an episode of intermenstrual bleeding on the probability of conception in a menstrual cycle (fecundability).

Design: Prospective, time-to-pregnancy cohort study.

Setting: Community-based cohort.

Bleeding after laparoscopic supracervical hysterectomy managed with cervical artery embolization. A case report.

Background: Postoperative bleeding is a known complication after laparoscopic supracervical hysterectomy (LASH), and trachelectomy is the traditional management of significant bleeding.

Case: We present the case of a patient with significant postoperative bleeding 1 month after LASH, resulting in symptomatic anemia requiring blood transfusion. Gelfoam embolization of the bilateral cervical arteries was successful in stopping the bleeding.

Age-related infertility.

Oocyte number and quality decrease with advancing age. Thus, fecundity decreases as age increases, with a more rapid decline after the mid-30s. Patients more than 35 years old should receive prompt evaluation for causes of infertility after no more than 6 months of attempted conception.

Pneumomediastinum after robotic sacrocolpopexy.

Background: Pneumomediastinum is a rare but potential complication of laparoscopy that is related to insufflation with carbon dioxide gas and may lead to life-threatening complications.

Case: A 76-year-old woman underwent robotic sacrocolpopexy to repair posthysterectomy prolapse without any apparent intraoperative complications. Postoperatively, she developed shortness of breath and tachycardia and was found to have subcutaneous emphysema and pneumomediastinum.

GATA augments GNRH-mediated increases in Adcyap1 gene expression in pituitary gonadotrope cells.

Pituitary adenylate cyclase-activating polypeptide 1 (PACAP or ADCYAP1) regulates gonadotropin biosynthesis and secretion, both alone and in conjunction with GNRH. Initially identified as a hypothalamic-releasing factor, ADCYAP1 subsequently has been identified in pituitary gonadotropes, suggesting it may act as an autocrine-paracrine factor in this tissue. GNRH has been shown to increase pituitary Adcyap1 gene expression through the interaction of CREB and jun/fos with CRE/AP1 cis-elements in the proximal promoter.

Pituitary adenylate cyclase-activating polypeptide (PACAP) in the hypothalamic-pituitary-gonadal axis: a review of the literature.

Pituitary adenylate cyclase-activating polypeptide (PACAP), an ancient molecule highly preserved across species, has been classified as a member of the secretin/glucagon/vasoactive intestinal peptide/growth hormone-releasing hormone polypeptide family. PACAP was first identified as a hypothalamic-releasing factor; nevertheless, it has subsequently been determined to have widespread distribution and function, including expression in the pituitary, gonads, placenta, central and peripheral nervous systems, intestinal tract, and adrenal gland. Consistent with its widespread distribution, PACAP has been found to exert pleiotropic effects.

Under the influence with a child in the car: implications for child safety and caregiver intervention.

Background: Injury is the leading cause of death for those aged 1 year to 44 years in the United States, with motor vehicle collisions (MVCs) the leading cause of injury-related deaths. Little data exist on the relationship between caregiver alcohol and drug use at the time of MVC and child passenger outcomes. We examined the relationship between caregiver substance use in MVCs and a number of demographic, crash severity, and medical outcomes for caregivers and children.

Efficacy of an accelerated hepatitis B vaccination program during pregnancy.

Objective: To estimate the feasibility and immunogenicity of an accelerated hepatitis B vaccination schedule of 0, 1, and 4 months in high-risk pregnant women.

Methods: We conducted a prospective clinical trial of high-risk pregnant women who were hepatitis B surface antigen-negative at presentation for prenatal care. A detailed questionnaire was administered and eligible women received a hepatitis B vaccine intramuscularly on a 0-, 1-, and 4-month schedule.